Pneumonia is a common lung infection that can cause coughing, chest pain, and difficulty breathing. It can also be deadly. Each year, approximately 50,000 Americans die of pneumonia, according to the Centers for Disease Control and Prevention (CDC). Of course, pneumonia isn’t always deadly. ‘Walking pneumonia,’ for instance, is a form of the disease that’s so mild, it barely interferes with your usual activity. For most people, prompt diagnosis and treatment are key to minimizing the negative effects of this lung infection; the sooner you seek medical attention for pneumonia symptoms, the sooner you’ll feel better. Watch for these five symptoms and signs of pneumonia. 1. Cough with phlegm Anything that irritates the lungs—smoke, infection, even chemical exposure—can cause a cough. Coughs also are a cardinal symptom of the common cold, which typically doesn’t require medical treatment. So how do you know if a cough is a symptom of a potentially serious medical condition, such as pneumonia? Pay attention to the cough over time. A cough that gets worse, instead of better, over time can be a sign of pneumonia; anyone who feels sicker rather than better after a few days of a cold or the flu should seek medical evaluation. It’s also a good idea to see a healthcare provider if you start coughing up mucus or phlegm, particularly if the mucus is thick, green or yellow. 2. High fever If you have persistent fever of 102 degrees Fahrenheit or greater, seek medical attention, especially if you also have a cough. Fever and chills are common symptoms of pneumonia. A really high fever—about 104 or 105 degrees F—may be a symptom of bacterial pneumonia. (Generally, the fevers that occur with viral pneumonia are not as severe.) If you are caring for an elderly family member or friend, also be alert for a lower-than-normal body temperature. People who are older than age 65 or have weak immune systems sometimes run low temperatures when they have pneumonia. 3. Chest pain If your chest hurts when you take a deep breath or cough, you might have pneumonia. Some people describe pneumonia-related chest pain as “sharp” or “stabbing.” The pain may get worse with activity. You may also feel fatigued and short of breath with even minimal activity, such as climbing a few stairs or getting dressed. That’s because pneumonia makes it hard for oxygen to move efficiently through your lungs and to the rest of your body. 4. Confusion Anything that causes sudden confusion or a change in mental alertness is a cause for concern. In people older than 65, new-onset confusion can be a sign of pneumonia (or another infection). That’s because pneumonia reduces lung’s ability to efficiently exchange oxygen and carbon dioxide, so people with pneumonia tend to breathe less deeply. Both of these factors reduce the amount of fresh oxygen to the brain. If you or a loved one experiences confusion or difficulty breathing, seek medical attention immediately. If you’re caring for someone who develops confusion but doesn’t appear to have any other symptoms, check their temperature and then call their healthcare provider to report your observations and findings. A full medical evaluation may be necessary. 5. Feeling worse, not better Usually, people get incrementally better over the course of a cold or other respiratory infection. If you suddenly feel worse again after a period of improvement, it’s likely you have a secondary infection—an infection on top of your initial infection. (When your body is busy fighting one set of germs, it’s easier for another germ to settle in and multiply.) Anybody who feels worse rather than better after a few days of respiratory symptoms should see a healthcare provider. How to prevent pneumonia Frequent handwashing, adequate nutrition, and plenty of sleep can help you avoid and resist the germs that cause pneumonia. People who are at high risk for serious complications from pneumonia should consider getting the pneumonia vaccine. The CDC recommends the pneumonia vaccine for: All children younger than 2 years All adults ages 65 and older Adults ages 19 through 64 who smoke cigarettes People ages 2 through 64 with certain medical conditions You can further decrease your risk of pneumonia by getting an annual flu vaccination. It’s not unusual for people to develop bacterial pneumonia after influenza. If you avoid the flu, you minimize your chances of getting pneumonia. Pneumonia symptoms in adults can be mild or severe. Walking pneumonia symptoms are typically mild, while more serious cases of pneumonia are characterized by high fevers, chest pain with breathing, shortness of breath, and a persistent cough. Always seek medical attention whenever you notice one or more of the warning signs of pneumonia. It will help you avoid even more serious complications, such as respiratory failure.